Sign of the times - Christopher Moreland

Imagine being on rotation in an emergency department. You hear a siren blaring as the ambulance pulls up. The man strapped to the gurney moans loudly as he's wheeled inside. Police officers are explaining what happened to the desk staff. And you're in charge of the patient.

Now imagine complete silence. All sounds providing important clues to your understanding of the case and your patient assessment are essentially non-existent. But you're still the doctor in charge.

Could you handle it? Could you treat the patient?

Silence is no barrier

Christopher Moreland goes through something like that everyday. Moreland, a second-year resident at UC Davis Medical Center, has been deaf since he was an infant. While Moreland is the first deaf physician at the medical center, he is one of a small but rising number of hearing-impaired health professionals around the country. There are an estimated 25 deaf physicians now practicing in the nation.

“There have been deaf physicians in everything from internal medicine and family practice to OB/GYN and radiology,” he says in an e-mail. “We have an association (Association of Medical Professionals with Hearing Loss — www.amphl.org) that is an amazing network of deaf and hard-of-hearing health professionals, including nurses, audiologists, veterinarians and many others.”

In person, Moreland has a friendly and thoughtful nature about him. He's easy with a laugh, quick in response, and patient with questions and answers — all characteristics of a good primary care physician, which is something he currently is leaning toward becoming as he works his way through his residency in internal medicine.

A variety of communications

Although he uses a variety of communications methods, Moreland relies on a sign language interpreter when meeting a patient or someone new at work. On this day, it's Todd Agan, who has been working with Moreland since he was in medical school at the University of Texas in Houston six years ago. As part of the effort to bring Moreland to Sacramento, UC Davis School of Medicine hired Agan and another interpreter, Cathy Bain, to work with the 29-year-old resident.

Agan's quiet presence makes for easy conversation with Moreland, who responds verbally after reading lips and getting details from his interpreter. During clinic, Agan or Bain accompanies Moreland as he sees each patient.

Despite being unable to 'hear' in the normal sense, Moreland uses a stethoscope like any other physician. It's an electronic stethoscope, which converts sounds into digital signals that are then plugged into his cochlear implant for listening to patients' heartbeats and lung sounds. It's a practice that essentially makes him no different from his colleagues although he notes with amusement that every resident has toys in their pockets, he just has a few extra.

“The auscultation (listening) process consists of hearing certain patterns,” says Moreland. “I can hear pitch, heart rate and patterns like that with my e-scope. While I can't exactly tell you what my colleagues hear, I am able to reach the same conclusions as a hearing physician, who can discern different sounds in the lungs and heart.

The path to medicine

Perhaps it's now surprising to those who know him, but medicine wasn't Moreland's first career choice.

“I fell into it,” he says. “In college I passed from major to major.”

First he tried computer science. Then, like any other undergrad, he dabbled in theatre, linguistics and anthropology. He loved each, but didn't realistically see himself establishing a stable career in any of them. Then he tried pre-med.

Medicine combined several characteristics that Moreland liked — science, human interest, and communication. He went to medical school, where he was elected to Alpha Omega Alpha (AOA), the honor medical society, in his third year.

Inspiring others

Although he's sometimes uncomfortable in talking about himself, Moreland is happy to share his unique experience. He doesn't consider being deaf all that challenging.

“For me that's normal. I grew up deaf. Interacting with the world as a deaf person is not out of the ordinary for me. It's difficult, but not more difficult than other things I've done. My deafness is at the core part of my identity. I can't filter it out.”

That identity and knowledge is one of the reasons why he also volunteers with the association of hearing-impaired medical professionals. It's a great way to help others make their way through the rigors of the medical world. Not a week goes by that he doesn't receive an e-mail from someone who's deaf and seeking insights into the education and training experiences he's mastered. In response, Moreland can provide everything from helpful tips about the right type of electronic stethoscope to more sage advice about working alongside experienced colleagues or putting patients at ease.

“I'm a huge fan of Chris,” says UC Davis residency program director, Mark Henderson. “He has been a superb resident in all respects and a wonderful addition to our program. Hiring two interpreters was a very worthwhile investment in a very special physician. He's someone who's been an inspiration to many people. And not only that, but he now has a group of hearing-impaired patients who literally sought him out to be their physician because of his unique communication abilities.”

Moreland isn't the first person at UC Davis School of Medicine to face physical challenges during the medical training process. In the past 25 years, the school has seen two quadriplegic students graduate and, currently, it has a hearing-impaired student well on her way to graduation, too.

“Medicine is a team effort,” Moreland says. “When I first visited the medical center's campus and met some of the people working here, I felt that everything just clicked — that being here would be a good fit because each person contributes something and helps to build what is a great medical team.”

Moreland will complete his residency in June of 2008. He's not quite sure where he'll end up in practice, but wherever he goes, it no doubt will be to the good fortune of both co-workers and patients alike that he listened to the call of medicine. Perhaps it's a sign of the times.